Green Hospitals: The Low-Carbon Future of Healthcare Saves Wisconsin Residents (a Lot of Money)

Gundersen Health Systems started down a path to energy independence just as the country was plunging headlong into the Great Recession,  building greener hospitals to combat healthcare’s cost crisis. In 2009, Gundersen’s visionary CEO, Dr. Jeff Thompson believed economic conditions presented an opportune moment to deploy an array of clean energy technologies to eventually save millions of dollars across its hospitals and clinic.

Tapping into the local business community in La Crosse, Wisconsin, and with the backing of Gundersen’s Board of Directors, the resourceful Gundersen Envision team overseeing the energy independence strategy identified ingenuous local, renewable energy sources, including methane flares from the local brewery, cow manure from local farms, wood from local timber interests, and an aquifer below an old Mississippi River tributary. Widespread renewable energy solutions like solar, wind, and geothermal also played a big role.

Snapshot

Tapping into the local business community in La Crosse, Wisconsin, and with the backing of Gundersen’s Board of Directors, the resourceful Gundersen Envision team overseeing the drive toward energy independence identified ingenuous local, renewable energy sources, including methane flares from the local brewery, cow manure from local farms, wood from local timber interests, and an aquifer below an old Mississippi River tributary. More widespread renewable energy solutions like solar, wind, and geothermal also played a big role.

Alan Eber, who for fifteen years worked on and eventually led Gundersen’s effort, and his hand-picked team have become the healthcare industry leaders of the low-carbon economy.

Capitalizing on Gundersen’s institutional knowledge, unparalleled experience, and nuanced set of processes for spotting, assessing, and deploying clean energy initiatives, Alan and a team from Gundersen recently launched a consultancy called Eneration to lead other large health systems looking to do the same—reduce energy demand, prevent carbon emissions, create savings, and improve local health.

Armed with Six Sigma black belts and all of the hard-earned experience from launching and growing innovation programs at Gundersen, it’s hard to imagine a more qualified team.

We recently spoke to Alan Eber on the Supercool podcast. An engineer by training, Alan started designing HVAC equipment before he was recruited into healthcare operations, infrastructure, and development.

Listen to the full interview with Alan Eber

“So I ran the facility maintenance, construction, real estate, environmental compliance, all kinds of different departments,” Alan recalled. Things really picked up with the development of a 430,000-square-foot addition to the hospital. And the realization that the mission of health care is not to take sick people and make them better but to improve the health of the communities that you’re serving.

In this frame, Alan points out,

We were doing two things that were harmful to our community. One is we were costing them money because we weren’t being very efficient. And two is we were creating all of these pollutants with our operations.

As any good engineer would do, Alan and the team conducted a large data study to identify the biggest opportunities to reduce energy. That’s because reducing energy usage is always less expensive than generating new energy. Says Alan,

“We walked these facilities for a couple of days and identified every opportunity to reduce energy. Within three years, we were able to reduce the energy usage by 35% – a massive reduction.”

Every dollar saved by efficiency fed directly into Gundersen’s bottom line and increased support for Alan and his team. Having built trust with the CFO and Board of Directors, the team was able to turn its attention from energy savings to renewable energy generation.

The first clean energy project occurred offsite, a collaboration with a local brewery, and it changed how Alan and the team looked at energy generation. Methane was a byproduct of the brewing process, and distinctly unpopular around town. According to Alan,

“Everybody in La Crosse knows when the methane is being burned because, number one, you can see the flame for quite a ways. Number two, there is an odor about that flame.”

His team approached the brewery about installing an internal combustion engine. Instead of flaring the methane, i.e., burning it, they combined forces to make electricity with it, which they sold back to the energy grid. By developing this renewable energy project, Gundersen was able ot offset its own energy footprint, turned one of the worst greenhoue gas offenders into a revenue stream for the local brewery, and delivered heat right back into the brewery’s building.

Next, Gundersen considered wind energy but quickly encountered statewide regulatory hurdles. Though Gundersen could have built large-scale wind farms to offset its entire energy usage, exceeding 5 megawatts of energy production per wind farm would require Gundersen to build cost-prohibitive utility grade infrastructure.

Instead, Alan and his team oversaw the development of two wind farms, one in Wisconsin, the other in Minnesota, both generating the maximum allowable 5 megawatts of energy.

So Gundersen still had to devise additional renewable energy strategies to achieve their goal of energy independence.

The culture of business and healthcare

85-90% of hospital workers provide patient care. Their job is to improve people’s health, not think about carbon footprints. The stakes are incredibly high for healthcare professionals as are the energy costs of delivering care. But as Alan and his team discovered, energy usage is a business culture challenge, one that can be overcome.

So the Gundersen Envision team started a new internal campaign. An email went out to all staff, reminding them to shut off lights, take the stairs in place of the elevators, turn off projectors in conference rooms, and so on. The hospital staff responded. Within minutes, real-time energy usage was dropping.

Yet, the real culture-shifting magic occurred when the second message went out.

The second email to all hospital staff delivered the results that ensued from their collective efforts. The data showed a direct connection between the first email, the actions that followed, and energy reductions, projecting the hospital would save $20,000 in the next two months. The direct feedback generated buy-in across the organization and also caught the attention of the CFO.

Alan and team quickly discovered that tying their efforts to pro forma financial analyses showing a clear benefit to the bottom line was highly effective for pitching and launching new energy-saving initiatives. Better still, tying those savings to upgrading to new more energy efficient medical equipment that would make delivering care easier and better for doctors and other medical staff definitely helped.

What they learned about changing behavior and shifting priorities through their internal communications strategy was equally valuable among their partner network. “There’s so much information and so many different technologies out there. No one person can be the expert in any of these things,” Alan told us during the podcast interview. Sometimes, that meant finding the right experts from the energy industry and building a relationship over time, and just as often, that meant tapping the local professional network and understanding the opportunities availalbe in Wisconsin.

So, when it was time to tackle the biggest challenge, the 2.2 million square foot campus, a moment that Alan describes as one of the scariest of his professional life, they found a local energy source that seemed so unlikely they almost didn’t consider it is as an option. There is a large legacy wood industry in the areas that surround La Crosse.

“So we did a deep investigation, talked to a lot of manufacturers, went on different site visits to go see other people that were burning wood to provide steam and heat. In the heart of downtown La Crosse, we put in an 800-horsepower boiler that generates high-pressure steam. We’re 300 yards from our healthcare system; we can’t have campfire smoke. But we went on these site visits and saw, you don’t even know that these things are running if it’s done right.”

Not only did they make steam with that project, but they also took that steam through a turbine generator and produced electricity, a combined heat and power source. Electricity is a byproduct that goes directly into the large clinic on campus.

The project replaced $1.2 million of energy spent on grid power at a cost of $500,000. The multiple benefits included:

• • Net savings of $700,000
  • An injection of $500,000 into the local economy
  • Avoiding purchases of natural gas that must be shipped from as far away as Texas or North Dakota
  • Switching to a renewable energy source

Equally important to Alan, “These are some of the greatest people I’ve had the opportunity to work with in my career. They would come and shake my hand. There was no paper being signed, but when this person shook my hand, what [they] said was going to happen. And I just love working with people like that.”

Wisconsin cows and dairy digesters

Wisconsin is a beautiful state, especially in the warmer months. Among the most unique and beautiful places in La Crosse, Wisconsin, are the bluffs, stunning rock formations overlooking downtown to the East and surrounded by nearly 1,000 acres of protected forests.

Wisconsin also lives up to its reputation as Dairyland, and cows are quite a common sight. With all these engineering minds roaming around the region, looking for ways to generate or capture heat, it was only a matter of time before they hit upon cow manure.

Gundersen partnered with three family farms in Dane County to develop two dairy digesters that utilize manure from about 2,000 cows to feed methane generators, similar to the brewery project downtown. The system is essentially a tank that heats up the manure and captures the methane that collects at the top of the tank. The methane generators create electricity. Excess heat from the generators warms the digester. It’s very efficient, and the manure left behind is still useful as fertilizer after the methane is extracted.

More precisely, the system is a tank within a tank. Says Alan,

“When we first started these projects, there was another project that had a failure and the slurry spilled out over the land. That hit the news in Wisconsin big time, and everybody was up in arms about it. So we put a secondary barrier around it in case our first barrier failed.”

The digester operation generates about 16 million kilowatt hours of electricity annually, enough to power approximately 2,500 homes (or 14% of Gundersen’s energy needs) and reduces fossil fuel carbon dioxide by 11,000 metric tons per year. The project also prevents 3,700 pounds of phosphorous runoff to local waterways and requires a small team, creating 6 full-time jobs.

Geothermal in every building and a microgrid

As the enterprise grew, Alan and team had to expand with radical efficiency. Without it, they stood to fall further behind their goal.

“We use geothermal, and that is an extraordinary way to reduce your energy usage. And we have two buildings. Gunderson has two buildings now that don’t have any natural gas hookups at all. They’re 100% electrified,” says Alan. In both of those buildings, Gundersen successfully offset all of the energy used; one building is 100% net-zero energy in downtown Elroy, Wisconsin. Alan tells us it’s “one of my favorite buildings that we built.”

He elaborates on this affection by explaining that when they burn methane or wood – and this is universally true – there is always some loss. If you’re really lucky, you might be 92% efficient, meaning 92% of that energy source turns into the energy you want. But with geothermal, they’re simply moving temperature, moving energy. And you can move energy three times more efficiently than you can burn something, hence geothermal is becoming widely used, it’s an increasingly global technology.

“So we have a project on our Onalaska campus that has about 400,000 square feet and three different facilities. It’s a large clinic, an office building that contains a data center, and then a renal dialysis center. And on that campus, we have an engine that makes heat for the clinic and the support building.”

“It’s powered by methane again. But this methane comes from a local landfill. Once you close up a landfill, it generates methane and then they have to flare that. So the county landfill, which happens to be a very progressive organization, approached Gundersen about methane.”

They no longer flare it; now, they capture it, clean it, compress it, and cool it. Then, they pipe it to Onalaska underground, meaning that the campus has its own pipeline from the landfill.

As it turned out, they made more electricity from landfill gas at Onalaska than they could use. Gundersen realized they were wasting a lot of heat, especially during summer. Ever resourceful, they installed an absorption chiller, which uses heat to generate cold water, which enabled the Onalaska campus to cool its office building and data center.

Earlier this year, Gundersen announced a partnership with Excel Energy to further upgrade the Onalaska health clinic into the first 100% resilient and renewable energy healthcare campus in the United States. The project entails adding a 1.5 Megawatt battery and control system. Now, instead of sending excess renewable power back to the utility, Gundersen will capture and store power for use at its own facilities.

Says Alan, “We charge our battery, put the power into our facilities so that when the power goes off, you know if the utilities shut down for some reason, we still have the ability to maintain our operations at a hundred percent.”

How energy efficiency lowers the cost of healthcare

Gundersen’s drive toward renewables and energy efficiency is exemplary in the healthcare industry—or really any industry. But what stands out as Supercool is the organization’s ability to combine climate innovation with benefits not just for the health system but also for the local communities it serves.

Gundersen is in the unique position of owning the health insurance plan for its patient population. As such, it’s been able to leverage its energy cost savings to control healthcare costs.

As Alan notes, Gundersen has been able to reduce the increasing cost of care to their patients – year over year for 18 consecutive years. “When we compared that to the national average, it was dramatically lower than the national average, and even the average here in the state of Wisconsin. You know, there was a pretty dramatic difference between how fast we were reducing our cost versus others.”

Even in its new iteration as Emplify Health, Gundersen will continue to cut energy costs across its healthcare system. Bellin saw the value in this work prior to the merger and will look to accomplish similar results at its own facilities.

Alan Eber and the team at Eneration will also help other hospital health systems drive down their operating costs.

It’s certainly working in Wisconsin.

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